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Three-dimensional analysis of patterns of locoregional recurrence after treatment in breast cancer patients: Validation of the ESTRO consensus guideline on target volume

 Jee Suk Chang  ;  Hwa Kyung Byun  ;  Jun Won Kim  ;  Kyung Hwan Kim  ;  Jeongshim Lee  ;  Yeona Cho  ;  Ik Jae Lee  ;  Ki Chang Keum  ;  Chang-Ok Suh  ;  Yong Bae Kim 
 RADIOTHERAPY AND ONCOLOGY, Vol.122 : 24-29, 2017 
Journal Title
Issue Date
Adult ; Aged ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy* ; Consensus ; Female ; Humans ; Mastectomy ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging* ; Practice Guidelines as Topic ; Tomography, X-Ray Computed/methods* ; Tumor Burden
Breast cancer ; CTV ; ESTRO ; RTOG ; Recurrence patterns ; Supraclavicular lymph nodes
BACKGROUND AND PURPOSE: To explore the validity of the ESTRO-clinical target volume (CTV), we conducted three-dimensional analyses of locoregional recurrence (LRR) patterns according to the ESTRO- and RTOG-CTVs. Moreover, we explored which factors contribute to metastasis development outside the recommended CTV. MATERIALS AND METHODS: We identified patients with post-treatment LRR explicitly exhibited on computed tomography (CT) images. All recurrences on CT were overlaid on representative CT images at the equivalent location, based on reference anatomic structures. RESULTS: A total of 235 recurrent lesions were identified in 129 patients. We depicted all LRR patterns in relation to the ESTRO- and RTOG-CTVs on CT and maximum intensity projection images. The ESTRO-CTV successfully contained the extent of the LRR within the RTOG-CTV in 96.4% of all early-stage breast-conserved women. Geographic misses of local recurrence were frequently observed in mastectomy patients (P=.002) and tended to originate from deep, but thin, chest walls. The rate of geographic misses of regional recurrence was low (3.6%) at the early stage, but increased in patients aged <45years and with triple-negative tumors (P<.05). CONCLUSIONS: Application of the ESTRO-CTV in early-stage disease seems justified.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Byun, Hwa Kyung(변화경) ORCID logo https://orcid.org/0000-0002-8964-6275
Suh, Chang Ok(서창옥)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Jeong Shim(이정심)
Chang, Jee Suk Paul(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
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